Tag: Medicare Reimbursement

AHA’s Recommendations for Inpatient Medicare Reimbursement in FY22

AHA’s Recommendations for Inpatient Medicare Reimbursement in FY22

AHA urges CMS to reassess inpatient Medicare reimbursement for organ acquisition and modify the distribution of residency slots as part of the FY 2022 IPPS proposed rule. The American Hospital Association (AHA) released comments on CMS’s FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule, which would increase inpatient Medicare reimbursement rates by $2.5 billion. […]
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HRSA_ Over 5M Claims Paid for Uninsured COVID-19 Vaccinations

HRSA: Over 5M Claims Paid for Uninsured COVID-19 Vaccinations

The Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured, a program funded by pandemic-related legislation […]
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CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

  CMS will increase Medicare payments by $35 per dose to administer at-home COVID-19 vaccines in an effort to increase the vaccination rate among beneficiaries. Medicare payments will increase by $35 per dose for providers who administer at-home COVID-19 vaccinations for Medicare beneficiaries, CMS announced today. In alignment with President Biden’s goal of ensuring vaccine […]
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Health Policy Experts Offer 3 Fixes for Medicare’s ‘Dysfunctional’ Advanced-Imaging Payment System

Health Policy Experts Offer 3 Fixes for Medicare’s ‘Dysfunctional’ Advanced-Imaging Payment System

  Medicare Radiology Payment System approach to advanced imaging reimbursement has been “dysfunctional” for decades, but health policy experts have a few suggestions to fix it. Over the past 20 years, the federal payment program witnessed “substantial” increases in the performance of MRIs, CT scans and nuclear studies, mostly in doc offices. A shift later […]
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CMS Proposes Medicare Payment Bump for Rehab, Psychiatric Facilities

CMS Proposes Medicare Payment Bump for Rehab, Psychiatric Facilities

  CMS has released the proposed rules for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the Inpatient Psychiatric Facility Prospective Payment System for fiscal year (FY) 2022. Issued yesterday, the proposed FY 2022 IRF Prospective Payment System rule would increase Medicare payments by 1.8 percent, or $160 million, compared to the previous fiscal year. The […]
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Append Surgical Modifiers With Confidence

Append Surgical Modifiers With Confidence

Modifiers 79: Know how to differentiate modifiers 79, 78, and 58to ensure proper reimbursement for all procedures performed. Modifiers convey important information about a claim and can directly affect reimbursement. But choosing the most appropriate modifier can be confusing — especially when two or more modifiers have similar descriptors. Modifiers 58, 78, and 79 are all […]
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CMS Releases Highly Anticipated Medicare “Breakthrough” Coverage Final Rule

CMS Releases Highly Anticipated Medicare “Breakthrough” Coverage Final Rule

The final rule also clarifies the definition of “reasonable and necessary.” On Jan. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule creating a new Medicare coverage and reimbursement pathway for “breakthrough” medical devices. Durable medical equipment (DME) providers and long-term care facilities (LTCFs) and hospitals that render DME services, read on! Medical device […]
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CMS Finalizes 2021 Physician Fee Schedule, Including E_M Changes

CMS Finalizes 2021 Physician Fee Schedule, Including E/M Changes

After some delay due to the COVID-19 pandemic, CMS has released the final rule for the 2021 Medicare Physician Fee Schedule. The final rule unveiled by CMS yesterday evening will dictate how much Medicare physicians get paid for delivering care starting January 1, 2021. In the rule, CMS finalized a conversion factor of $32.41, which is a […]
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CMS Expands Medicare Reimbursement for Home Dialysis, ESRD

CMS Expands Medicare Reimbursement for Home Dialysis, ESRD

New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule. CMS released the final rule yesterday, which introduced the new transitional add-on payment for dialysis machines used in patient homes and also included an update to Medicare reimbursement rates […]
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